Embryos: How many should be transferred?
You might think that if you transfer two embryos, then the chances of one sticking goes up, but that’s not always the case.
Many couples enter their surrogacy journey with the idea that having twins will make their family complete in one fell swoop. If the final goal is two kids, then twins means that the intended parents (IPs) don't have to go through the surrogacy process again. However, it isn’t always that easy. Below are a few things to consider when deciding whether to transfer one or more embryos.
A lot of times IPs haven’t considered the increased risk that a multiple pregnancy presents to the surrogate and the babies. Multiples have a higher chance of being born prematurely, which can cause a lifetime of problems. Multiples also increase the risks for the surrogate, with common risks being gestational hypertension, preeclampsia, gestational diabetes, and placental abruption. While these are all risks with a singleton pregnancy, the risk increases considerably with multiples.
More doesn’t always mean better
You might think that if you transfer two embryos, then the chances of one sticking goes up, but that’s not always the case. One study done in the UK found that if two embryos of unequal quality were implanted (ie; one is good or very good and the other poor), then there was actually a 27% decrease in successful implantation.
Usually the surrogate gets an extra few thousand dollars if she carries twins, so the IPs may think they are getting a good deal by not having to go through the whole surrogacy process again. However, they may have not factored in the increased cost of medical bills if the twins spend time in the NICU. The surrogate might also go on bed rest, which would mean the IPs usually cover the cost of childcare, missed work, housekeeping, etc.—then there’s the increase in medical bills for the surrogate if she has complications. It can all add up to cost more than the cost of two singleton surrogacies.
Now that we got some of the negatives out of the way—who doesn’t love twins? A lot of people hope to have twins. It’s a baby times two and double the cuteness! I know I always stop to stare at twins because they are just so cute. Cuteness aside, it's important to carefully consider and discuss with the reproductive endocrinologist the correct number of embryos to transfer.